A lot can happen in four years – an education, a first experience of independence, a few bad decisions and a few good ones, and for some students, an encounter with new or existing mental health issues.

“We see it all from a mental health standpoint – students who are adjusting to leaving home and coming to new place, all the way to a first psychotic episode,” said Brian Quigley, MD, director of psychiatry at the WELLWVU Carruth Center for Psychological and Psychiatric Services.

The Carruth Center is the mental health component of WELLWVU, the student health service at WVU. The center is accredited by the International Association of Counseling Services and provides a full range of psychological and psychiatric clinical services to full- and part-time undergraduate, graduate, and professional students.

“This is sort of a watershed area,” Dr. Quigley said. “What students take away from here, they’re going to bring back down the line to wherever they go. We hear this a lot – that it affects how people at home are thinking about mental illness.”

Fortunately for students, the Carruth Center is not simply a high-quality mental health clinic. It also gives them access to an entire university’s worth of resources that would not be found in most community clinics.

From alcohol prevention training on an outdoor challenge course to a clinic on fine-tuning the brain to maximize attention and memory, the Carruth Center is pioneering mental health therapies that can help WVU students, their families, and their state.

Rxercise: Movement for mental health

Peter* struggled with depression and low self-esteem. He wanted to try WELLWVU’s Movement for Mental Health (M4MH) program, but he was uncomfortable with going to the gym or other usual workout areas. Peter’s coach worked with him to develop a creative strategy that Peter felt good about. Peter already walked to class every day, so they varied his route to challenge him physically. Later, the coach introduced exercises Peter could do at home. Peter ultimately was able to build his confidence and reduce his depression in a personalized environment where he felt comfortable and competent.

Nearly 80 percent of Carruth Center clients struggle with depression or anxiety. The M4MH program, offered through the WELLWVU Office of Wellness and Health Promotion, partners with the Carruth Center to empower students like Peter to use exercise to manage mild to moderate depression, anxiety, and high levels of stress.

“One thing I really like about this program is that it relates exercise to a way of being or a way of feeling, and not a way of looking, which I have found really resonates with students,” said Shannon Foster, MS, the WELLWVU health education specialist who launched the program in 2012.

Rather than ask for weight or body fat measurements, the 12-week program asks students how they feel and suggests individually tailored workout ideas to address his or her specific feelings, such as using low intensity workouts like walking or yoga to ease anxiety, or vigorous workouts like strength training or running to counter feelings of depression.

Laci* had already been using exercise to manage her stress, but after she had her first panic attack in a group exercise class, any exertion or rise in heart rate brought back feelings of panic. She felt stressed, anxious, and cut off from her usual outlet. Through personalized coaching with the Movement for Mental Health program, she learned to monitor her own heart rate and dissociate the feeling of exertion from the feeling of a panic attack. In only eight weeks, Laci returned to her usual routine, taking control of both her stress and her anxiety.

“It’s really about helping the student to feel confident and have the self-efficacy that they can do it on their own,” Foster said.

MindFit

Just a few weeks after returning to WVU for her professional degree, Mary* was under academic review and at risk of being asked to leave. She turned to the MindFit program at the Carruth Center.

MindFit launched in 2009 in response to an overwhelming number of students requesting stimulant medications for ADHD. Daniel Long, PhD, psychologist and coordinator of MindFit and Assessment Services, was dissatisfied with the options available to struggling students – mostly tutors and evaluation for medication. He began began implementing non-medication cognitive enhancement interventions driven by cognitive science, using tasks and coaching by an expert in cognition to strengthen weak areas.

When Mary came to the clinic, her attention scores were considered severely impaired. In just a month, she raised her scores to high-average, and by the end of her training, she scored in the superior range.

The MindFit Clinic is pioneering a unique brain training technique using neurofeedback technology. Dr. Long describes it as holding a mirror to the brain. Electrodes on the participant’s scalp project an image of the brain’s function on a screen while he or she performs a task. The brain can then use that information about itself to optimize its performance, much like watching yourself in the mirror to learn a new dance move.

“What we’re doing here at WVU is really special, and almost no one else is doing this kind of thing. We’re ahead of the curve,” Long said. “We can implement programs from this clinic statewide to help improve who we are as a state and what we’re able to achieve, educationally and otherwise.”

High Expectations

Students who have been cited for alcohol abuse at WVU often come to their mandatory alcohol prevention education sessions with their defenses up, making it very difficult for them to learn the information they need. They may feel under attack from the judicial system, the university, and their parents.

High Expectations is a two-session alternative alcohol prevention course through the WVU Student Assistance Program that takes place on the Adventure WV Challenge Course. The program presents the same material as the classroom version but through games and activities outdoors.

“It’s really just a standard alcohol prevention education, but we use games,” said Deborah Beazley, LICSW, lead facilitator of High Expectations. “They call it isomorphic learning, but the idea is that if you’re enjoying yourself and you’re having fun, you remember things.”

The strength of isomorphic learning is its ability to break down students’ defensiveness so that they absorb the information being presented. High Expectations blends instruction and fun to create a non-threatening environment. In one game, a team represents a single partygoer as they cross a series of logs and platforms. Along the way they receive cards representing drinks and have to recalculate their BAC. If their imagined BAC gets too high, they may have to wear goggles or a blindfold to simulate impaired vision or blackout.

This alternative approach to alcohol prevention seems to be working. Preliminary research shows that High Expectations students cut back their drinking a little bit more and for a little bit longer than their classroom counterparts.

And Beazley hopes the students take away more than just responsible drinking habits. “We want West Virginians to love West Virginia,” Beazley said. “We hope by having spent those eight hours outdoors or playing games, maybe they’ll think about choosing the outdoors as an alternative behavior to drinking.”

HelpWell App

A private, modern app that puts convenient mental health services directly in the user’s hand is making mental wellness as accessible to WVU students as possible. Launched in December 2014, the app was developed by the HelpWELL program, which focuses on suicide awareness and prevention with funding from the Substance Abuse and Mental Health Services Administration (SAMHSA).

The primary feature of the HelpWELL app is its wellness monitor. Each day users rate their mood, anxiety, and hours slept, and a chart of the week’s ratings displays on the home screen. Users can see trends, such as how their sleep affects their mood.

The app also includes a customizable list of wellness activities like meditating, taking a walk, or playing a game. Other features include reminders for wellness activities and rating your day, backlogging if you miss a day, quick links to mental health resources, and phone numbers to emergency contacts and crisis lines. The red “I need help now” button on the home screen prompts the National Suicide Prevention Lifeline as well as a list of mental health resources close to your GPS location.

“This app is a great tool for people who want to track their daily well-being and create healthy habits. I think what makes it truly unique are the built-in supports and ability to customize many functions, which allow the app to be utilized in many ways,” said Allison Cutlip, HelpWELL program coordinator.

The app is designed for WVU students, but the free download is available to anyone in the U.S. with an iPhone or other iOS device. A few of the resources are tailored to WVU’s campus, but the main features of the device — its wellness trackers and support resources — are available anywhere.

The HelpWELL app is just one way the Carruth Center is making mental healthcare available when and where it is needed. Students are taking it home with them and, one download at a time, helping to normalize mental healthcare in West Virginia.

*Names have been changed.